Important Notice – You May Be Eligible for Medicare Part D Subsidies



TO: Fresno Unified School District Retirees and Spouses Enrolled in Elixir RxPlus Prescription Drug Plan or Kaiser Permanente® Senior Advantage Plans (Medicare Part D plans) 

RE:  Eligibility for Medicare Prescription Drug (Part D) Subsidy as a Result of Part D IRMAA Premium Rules 

DATE: November 15, 2021

As a Medicare-eligible retiree (or spouse of a retiree) currently enrolled in the Elixir RxPlus (fka EnvisionRx Plus) Medicare Part D plan or Kaiser Permanente Senior Advantage Plan you may be eligible for subsidies from the District’s Joint Health Management Board (JHMB) for your 2022 Medicare Part D prescription drug premiums. 

How It Works

As a result of a federal regulation that went into effect in 2012, certain higher-income Medicare beneficiaries are subject to additional Medicare prescription drug premiums. This additional premium is known as the Part D Income-related Monthly Adjustment Amount (IRMAA). The amount is calculated based on your federal income taxes filed two years prior to the plan year. In 2022, you may be subject to the IRMAA premium if you are a Medicare beneficiary whose modified adjusted gross income (AGI) on your most recent Federal tax return fell into either of the following categories: 

  • AGI of $91,000 or more – Individuals
  • AGI of $182,000 or more – Married Couples Filing Jointly

Though the Joint Health Management Board has agreed to subsidize your IRMAA premiums, it is still up to you to pay the premiums to Medicare.

What You Need to Do

If you received a notice/bill from the Social Security Administration or Medicare that your monthly Part D prescription drug premiums include an income-related monthly adjustment amount (IRMAA), simply follow the instructions below:

1. Please scan/email, fax, or mail a copy of your statement/bill from the Social Security Administration or Medicare to Delta Fund Administrators at the information below:

Delta Fund Administrators
Toni Sarris, Trust Specialist
PO Box 2330
Stockton CA 95201
Fax: (209) 940-5125

2. Make sure the statement/bill clearly indicates your monthly Part D or prescription drug IRMAA premium. Delta Fund Administrators will annualize your IRMAA premium based on the monthly amount and provide you a subsidy for the entire plan year.

3. Be sure to include your phone number or email address, should they need to follow up with you for additional information. You are not required to submit this information monthly – only one time during the plan year.

Pay Your Premiums

Though the Joint Health Management Board has agreed to subsidize your IRMAA premiums, it is still up to you to pay the premiums to Medicare. Delta Fund Administrators is not sending the money to Medicare on your behalf. If you fail to pay the premiums, you may lose your Medicare eligibility. So, be sure to continue to make your payments throughout the year.

2021 IRMAA Reimbursements

You may still submit documentation to receive your 2021 reimbursement, please follow the instructions provided in the “What You Need to Do” section above and send the required information to Delta Fund Administrators by December 31, 2022. 

If You Have Questions

Please contact Delta Fund Administrators if you have any additional questions. You may reach them at the following contact information:

Delta Fund Administrators
Toni Sarris, Trust Specialist
P: (209) 940-5225

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